MedSchool: Ace Your OSCEsThe Medical Company
GET - On the App Store
Haem History

Allogeneic Stem Cell Transplant

February 15th, 2021


An allogeneic stem cell transplant involves depleting a patient's bone marrow using chemotherapy, and then transfusing another (matched) patient's stem cells. This serves purposes of both replacing their haematopoietic cells with normal cells, and providing some degree of graft-vs-disease effect.
Allogeneic stem cell transplants are associated with a high risk of complications and mortality, and require long-term immunosuppression.
  • Ask About

  • Peritransplant history - when the transplant was done, indication, type of transplant, conditioning
  • Complications
  • Post-transplant management

Peritransplant History

  • Ask About

  • When
  • Indication for allogeneic stem cell transplant
  • Type of transplant - syngeneic, matched sibling, MUD, haploidentical, cord blood
  • Donor - HLA match, CMV status
  • Recipient - CMV status
  • Conditioning - myeloablative or reduced intensity (RIC)
  • Indications for Allogeneic Stem Cell Transplant

  • Acute myeloblastic leukaemia
  • Acute lymphoblastic leukaemia
  • Aplastic anaemia
  • Relapsed refractory lymphoma
  • Types of Allogeneic Stem Cell Transplant

  • Syngeneic allograft - identical twin donor with the same major and minor HLA antigens
  • Matched sibling allograft - all major HLA antigens matched; minor antigens more likely to match
  • Matched unrelated donor (MUD) allograft - major HLA antigens matched; minor antigens partially matched
  • Mismatched unrelated donor allograft- some major and minor HLA antigens matched
  • Haploidentical allograft (unmatched sibling, parent, child or other family member) - half of major HLA antigens matched
  • Cord blood allograft


  • Complications of Allogeneic Stem Cell Transplant

  • Infectious

  • Fungal infections - candida, aspergillus, cryptococcus
  • Viral infections - herpes simplex, varicella, CMV, EBV, influenza, BK virus, JC virus
  • Bacterial infections - mycobacterial, pneumococcal
  • Protozoal infections - pneumocystis, toxoplasmosis
  • Non-Infectious

  • Mucositis
  • Bone marrow suppression
  • Graft vs host disease (GVHD) - acute / chronic
  • Post-transplant lymphoproliferative disorder
  • Sinusoidal obstructive syndrome (jaundice, hepatomegaly, fluid retention)
  • Rejection
  • Disease relapse

Post-Transplant Management

  • Management Strategy

  • Transfusion support
  • GVHD prophylaxis - cyclosporine, methotrexate
  • Infective prophylaxis - e.g. bactrim, posaconazole, ganciclovir / valganciclovir
  • Vaccinations
Next Page
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now

Snapshot: Initialising...